1. Whole Body PET-CT Effective Dose calculations using Physico ® : an automatic dosimetric software. Fabio Tanzi 1, Andrea Ribolzi 2, Raffaele Novario 3, Carla Bianchi 1. 1) Struttura Complessa Fisica Sanitaria, Ospedale Di Circolo e Fondazione Macchi – Varese. 2) EMME ESSE M.S. SRL Via Giuba 11, 20132 Milano - ITALY e-mail: info@emme-esse.com. 3) Dipartimento di Biotecnologie e Scienze della vita, Università dell'Insubria, Varese. Roma, 24 settembre 2015

2. Physico ® : a software suite for Medical Physics and Radiation Protection. Physico is the result of a cooperation between The Medical Physics Dept. and Emme-Esse SRL. Our Medical Physics Dept. Is involved in all the types of activities related to: 1.Medical Physics (patient RP, radiological Machines QC, etc.) 2.Radiation Protection (Dosimetry LAB, personnel and environmental dosimetry, etc)

3. Physico ® : architecture (1). Physico ® is intended to provide the framework in which is supported: 1.Direct integration between RIS, PACS, Record & Verify, and Treatment Planning Systems, NM - NBP Software. 2.DataBase containing all the info retrieved from: 1.Medical Imaging 2.RT planning 3.NM Sources QC and administration 4.Environmental Active and passive Dosimetry 5.Personnel Dosimetry (active and passive).

4. Physico ® : architecture (2). Physico ® gives the users the full real-time control of: 1.Radioactive Sources DataBase 2.Radiological Machines Database (QC, Service Reports, etc.) 3.Radiometric Instrumentation DataBase, with cal. Certificates and alerts.

5. Physico ® : architecture (3). Physico ® gives the users the full, real-time control of: For Medical Physicist (D. lgs. 187/2000) 1.Patient Dosimetry 2.L.D.R. (Diagnostic Reference Levels) calculations and reporting 3.Radiological Machines and LINAC QC Dbase and Reporting For Radiation Protection Qualified Expert (D. lgs. 241/2000) 1.Radioactive Sources charge – discharge Registers 2.Personnel External Dosimetry 3.Environmental dosimetry 4.Personnel Internal Dosimetry 5.Personnel Radiation protection documentation (Scheda Dosimetrica Personale, Libretto Personale di Radioprotezione)

6. Physico ® : Features. 1.Architecture: LINUX (Debian ® or Ubuntu ® 14) 2.DataBase: Postgre with NVIDIA ® CUDA ® computation ! 3.WEB based Interface: you can use it by using a WEB Browser: no client installation ! Different user – levels: 1.Administrator 2.Medical Physicist/Qualified Expert 3.Technician

7. Patient Dosimetry Module:

12. Patient Dosimetry Module CT Organ Doses:

13. Patient Dosimetry Module: pediatric CT Organ Doses

14. Patient Dosimetry Module:

20. Some Results in PET-CT Attività (Mbq) CTDI totale Studio DLP Totale Studio Dose Efficace Impegnata Dose Efficace studio (AAPM96) Dose Efficace studio (ICRP 103) Incertezza Dose Efficace Studio(ICRP103) Dose Efficace Impegnata Dose Efficace studio (ICRP 60) Incertezza Dose Efficace Studio(ICRP60) Peso del Paziente (Kg) 1645,26458,653,1859058,1170405941,6855115273,1859057,325132961,4569998770 1134,75414,432,195166257,3300271521,5220874052,195166256,6149014371,31573182246 2025,3461,83,795868668,0963844061,6710751913,795868667,1877232071,40385544574 1364,96434,562,641977,6540915111,5893796912,641976,9073497111,37390101855 1555,19452,343,011068758,0090191411,6630807653,011068757,2276502021,43761013861 1973,82697125 80 30026,05617,715,63742871,2971915,637428783 5,7566,368,7074322861,7971940737,7301928831,509806799 1494,21367,162,894511256,4967188021,34905012,894511255,8628915891,16615388950 4,5392,356,8742886471,4188374266,1027838551,191952736 1825,34465,023,420040088,1574891941,6836870793,420040087,2419701751,4144505872 1487,37641,542,87508511,373115812,3616387742,87508510,263541812,04146179660 29526,23621,785,730743751,3057385,7307437550 1484,5392,42,781131496,8742886471,4188374262,781131496,1027838551,19195273660 2587,37733,134,8481886811,258557182,3237404074,848188689,995003781,952153704106 2354,415985820 95 28926,23621,95,614186251,305995,6141862563 1414,97555,282,739101257,6695231471,5925840852,739101256,9212758191,3766709857 30626,23618,175,750177271,2981575,7501772799 1285,36469,322,486568,2713569551,7175554722,486567,4643940431,48469948855 1803,4967250 72

21. Patient Dosimetry Module example: results on 110 Pet-CT studies

25. Conclusions: 1.Using this software it’s possible to analyze very large amount of dosimetric patient’s data coming directly from both DICOM Headers and DISCOM SR. 2.We processed data from 110 patients undergoing PET- CT WB examinations. 3.Results seems to validate the Lee Method (EFFECTIVE and Organ Doses) (in comparison with ImpaCT ® CTDosimetry ® Excel ® Worksheet) 4.The tool is very fast and allows (also) to calculate TC DRLs for our MN site.

26. Thanks for you attention !!